Evidence map›Paper›PMID 38750111›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2024

Retrospective analysis of the subscapularis-sparing approach for reverse total shoulder arthroplasty.

Marc-Frederic Pastor, Lea Kruckenberg, Alexander Ellwein, Roman Karkosch, Hauke Horstmann, Tomas Smith

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Safety and Efficacy of Subscapularis-Sparing Shoulder Arthroplasty Approaches: A Systematic Literature Review.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2026
    Pooled it
  2. Trial
  3. Does glenosphere size impact shoulder rotational range of motion after reverse shoulder arthroplasty? A retrospective cohort study.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Marc-Frederic PastorDepartment of Orthopedics and Trauma Surgery, Staedtisches Klinikum Braunschweig, Holwedestr. 16, 38118, Brunswick, Germany. f.pastor@gmx.de.ORCID http://orcid.org/0000-0003-3802-8941
Lea KruckenbergMedical School Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
Alexander EllweinOrthopedic Department of Medical School Hannover in Diakovere Annastift, Medical School Hannover, Anna-Von-Borries Str. 1, 30625, Hannover, Germany.
Roman KarkoschOrthopedic Department of Medical School Hannover in Diakovere Annastift, Medical School Hannover, Anna-Von-Borries Str. 1, 30625, Hannover, Germany.
Hauke HorstmannOrthopedic Department of Medical School Hannover in Diakovere Annastift, Medical School Hannover, Anna-Von-Borries Str. 1, 30625, Hannover, Germany.
Tomas SmithOrthopedic Department of Medical School Hannover in Diakovere Annastift, Medical School Hannover, Anna-Von-Borries Str. 1, 30625, Hannover, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe influence of the subscapularis tendon on reverse total shoulder arthroplasty (RTSA) has been discussed controversially. The aim of the study was to investigate the subscapularis-sparing approach for RTSA and the effect of the intact subscapularis tendon.

methodsThis retrospective comparative study included 93 patients. Among these, 55 underwent the deltopectoral subscapularis-sparing approach, and in 38 cases, the standard deltopectoral approach with subscapularis tenotomy was applied. At the final follow-up, representative shoulder scores were measured, radiographs were taken in two planes, and shoulder sonography was performed.

resultsThe subscapularis-sparing group showed a significantly higher Constant score (71.8 vs. 65.9 points) and adapted Constant score if the subscapularis tendon was shown to be intact in the postoperative sonography (85.2% vs. 78.6%) (p = 0.005; p = 0.041). Furthermore, these patients had improved abduction (128.2 vs. 116.8, p = 0.009) and external rotation (34.6 vs. 27.1, p = 0.047). However, no significant differences were found for the degree of internal rotation and internal rotation strength. No dislocation or infection was observed. The degree of scapular notching was not significantly different between the two groups (p = 0.082). However, independently from the integrity of the subscapularis the subscapularis-sparing approach showed no difference in clinical and radiographic outcome (Constant score scapularis-sparing 70.0 points vs. tenotomy 66.8 points; p = 0.27).

conclusionThe subscapularis-sparing approach RTSA showed improved clinical outcome, abduction, and external rotation, if the subscapularis was shown to be intact at time of follow-up. Both groups showed no difference in internal rotation.

Indexed as

Arthroplasty, Replacement, ShoulderRange of Motion, ArticularShoulder JointAgedAged, 80 and overFemaleHumansMaleMiddle AgedRadiographyRetrospective StudiesRotator CuffTendonsTenotomyTreatment OutcomeUltrasonographyDeltopectoralReverse total shoulder arthroplastyShoulder arthroplastySubscapularis-sparing approachSubscapularis tendon

Identifiers

PMID38750111

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.